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Measured behavioural latency in response to sex-pheromone loss in the large silk moth Antheraea polyphemus.

Males of the giant silk moth Antheraea polyphemus Cramer (Lepidoptera: Saturniidae) were video-recorded in a sustained-flight wind tunnel in a constant plume of sex pheromone. The plume was experimentally truncated, and the moths, on losing pheromone stimulus, rapidly changed their behaviour from up-tunnel zig-zag flight to lateral casting flight. The latency of this change was in the range 300-500 ms. Video and computer analysis of flight tracks indicates that these moths effect this switch by increasing their course angle to the wind while decreasing their air speed. Combined with previous physiological and biochemical data concerning pheromone processing within this species, this behavioural study supports the argument that the temporal limit for this behavioural response latency is determined at the level of genetically coded kinetic processes located within the peripheral sensory hairs.

Animals↗

Sudden daytime sleep onset in Parkinson's disease: polysomnographic recordings.

Sleep attacks in Parkinson's disease are controversially discussed. This paper describes a patient with Parkinson's disease suffering from sudden, irresistible onset of sleep during daytime. Medication included levodopa, entacapone, budipine, and cabergoline. Introduction of entacapone was the last therapeutic action preceding onset of sleep events, suggesting increased bioavailabilty of levodopa to be provocative in this case. In contrast to previous cases, the sudden sleep events were witnessed by clinical staff members and documented by polysomnographic and video recordings. Polysomnography during these sleep events remarkably showed abrupt slowing of EEG-background activity and occurrence of slow eye movements and K-complexes within 10 seconds after stable wakefulness. Within 60 seconds, the polysomnographic pattern proceeded to stable sleep stage 2.

Electroencephalography↗

Strength of mid-logarithmic and stationary phase Saccharopolyspora erythraea hyphae during a batch fermentation in defined nitrate-limited medium.

A method for measuring mechanical properties of Saccharopolyspora erythraea is reported with data from a batch fermentation. Briefly, hyphae were glued to the end of a tungsten filament mounted horizontally on a sensitive force transducer. Free ends of hyphae were trapped against a flat surface by a second probe. The force transducer and tungsten filament were then moved at a fixed rate, the hypha were strained, and the force resisting motion recorded. From these data the maximum force resisting motion is taken as the force at which breakage occurs. Hyphae from the mid-logarithmic phase of a simple batch fermentation on defined medium were found to have a breaking force of 890 +/- 160 nN (95% confidence), while stationary phase hyphae were weaker at 580 +/- 150 nN. Video recordings of the experiments allowed an approximation of breaking strain, which did not differ significantly between samples at 0.18 +/- 0.03. Electron microscopy was used to measure cell wall thickness, cell diameter, and hence cell wall cross-sectional area. The ultimate tensile strength was estimated to be 24 +/- 3 MPa with no difference between the two samples, the lower breaking force of the stationary phase hyphae being attributed to a thinner cell wall. Assuming a linear relationship between stress and strain, the elastic modulus was estimated to be 140 +/- 30 MPa. These values are comparable with other structural biological materials such as yeast cell walls and collagen.

Anti-Bacterial Agents↗

Undergraduate surgical teaching utilizing telemedicine.

OBJECTIVES: To evaluate the concept of a new telemedicine orientated educational application by exposing junior medical students to surgical teaching via video-conferencing from the operating theatre and comparing this to the traditional method currently employed, which requires the presence of students in the operating room. To determine student satisfaction with this novel method and identify deficiencies associated with traditional surgical teaching. DESIGN: Students were connected by video-conferencing equipment 2 Mbit/s permanent virtual circuits that provided two-way picture and voice communication. Traditional tutoring involved students attending the operating theatre in set numbers. Video recordings were made during the telemedicine transmission for highlighting important factors relevant to the operative procedure. A questionnaire was used to assess the quality of time spent and information obtained by the students. SETTING: Telemedicine centre and operating theatre, St Mary's Hospital, London. SUBJECTS: Junior clinical students. RESULTS: The median score for surgical teaching utilizing video-conferencing was 9 (scale 0-10) compared to 5 for traditional operating theatre surgical teaching. All 46 (100%) subjects indicated a willingness to return for the telemedicine influenced method of tutoring compared to 65% of students exposed to the conventional method. CONCLUSIONS: Our early experience with telemedicine assisted surgical teaching indicate high acceptance and satisfaction rates by clinical students. Further studies to evaluate the objective gain in knowledge associated with this method is required prior to its implementation in any future medical curriculum.

Consumer Behavior↗

Dynamic loads on the upper extremities during two different floor cleaning methods.

BACKGROUND: Biomechanical models have been used frequently to estimate the load on the low back and the lower extremities during occupational work tasks. The shoulder region has received much less attention although this area is a common site of work-related musculoskeletal disorders. OBJECTIVE: The aim of the present study was to evaluate the mechanical loading of the upper extremities during floor cleaning performed with different techniques. DESIGN: A comparative study of six subjects performing floor cleaning with two different techniques (mopping and scrubbing) in a laboratory setting. METHODS: A "force handle" equipped with two force dynamometers was used for continuous measurement of three-dimensional forces on each hand, separately, during this two handed asymmetrical task. A link segment model of the upper extremities was used to calculate the mechanical loading of the elbows and shoulders. Electromyograms were recorded from six shoulder muscles. RESULTS: Despite differences in movement patterns between mopping and scrubbing, only small differences were found in the moments of force. In accordance similar levels of electromyograms were found. CONCLUSION: In preventive strategies, changing the cleaning tool may not be sufficient to change the load on the shoulder muscles. RELEVANCE: Combined three-dimensional video recording and force measurements on the hands during a two-handed asymmetric work tasks allow calculation of the mechanical load on the elbow and shoulder. Thus it is possible to evaluate physiologically, new equipment designed to prevent work-related musculoskeletal disorders. Before introducing such equipment in large scale interventions it may be evaluated if the changes in force requirements are sufficient to predict prevention of musculoskeletal disorders.

Adult↗

A study of natural cytotoxic (NC) activity in the metrial glands of rats and mice.

Cell suspensions prepared from the metrial glands of rats killed on days 10, 13 and 20 of pregnancy and mice killed on day 12 of pregnancy were assessed for their ability to kill natural cytotoxic cell target Wehi 164 cells in a 51chromium-release cytotoxicity assay. High cytotoxicity indices were found with metrial gland cell suspensions from rats killed on days 10 and 13 of pregnancy and from mice killed on day 12 of pregnancy. Cell suspensions from rats killed on day 20 of pregnancy, when there are relatively few of the granulated metrial gland cells which characterize the metrial gland, had little natural cytotoxic cell cytotoxic activity. Direct observation of mouse granulated metrial gland cells killing co-cultured Wehi 164 cells were made using time-lapse video recordings. The results indicate that granulated metrial gland cells are a type of natural cytotoxic cell.

Animals↗

Patients' and physicians' understanding of health and biomedical concepts: relationship to the design of EMR systems.

OBJECTIVE: The aim of this paper is to examine knowledge organization and reasoning strategies involved in physician-patient communication and to consider how these are affected by the use of computer tools, in particular, electronic medical record (EMR) systems. DESIGN: In the first part of the paper, we summarize results from a study in which patients were interviewed before their interactions with physicians and where physician-patient interactions were recorded and analyzed to evaluate patients' and physicians' understanding of the patient problem. We give a detailed presentation of one of such interaction, with characterizations of physician and patient models. In a second set of studies, the contents of both paper and EMRs were compared and in addition, physician-patient interactions (involving the use of EMR technology) were video recorded and analyzed to assess physicians' information gathering and knowledge organization for medical decision-making. RESULTS: Physicians explained the patient problems in terms of causal pathophysiological knowledge underlying the disease (disease model), whereas patients explained them in terms of narrative structures of illness (illness model). The data-driven nature of the traditional physician-patient interaction allows physicians to capture the temporal flow of events and to document key aspects of the patients' narratives. Use of electronic medical records was found to influence the way patient data were gathered, resulting in information loss and disruption of temporal sequence of events in assessing patient problem. CONCLUSIONS: The physician-patient interview allows physicians to capture crucial aspects of the patient's illness model, which are necessary for understanding the problem from the patients' perspective. Use of computer-based patient record technology may lead to a loss of this relevant information. As a consequence, designers of such systems should take into account information relevant to the patient comprehension of medical problems, which will influence their compliance.

Cognition↗

Ultrasonographic confirmation of intraosseous needle placement in an adult unembalmed cadaver model.

STUDY OBJECTIVE: Intraosseous access is widely used in pediatric and adult resuscitations when vascular access cannot be promptly established. Confirmation of intraosseous needle placement has traditionally relied on the ability to aspirate blood or marrow or infuse crystalloid easily. This study's aim is to determine the value of bedside ultrasonography as a means of confirming intraosseous needle placement by visualizing the flow of crystalloid within the intraosseous space. METHODS: A controlled trial was conducted in which intraosseous access was obtained in the bilateral distal tibia of 4 freshly frozen, unembalmed cadavers. In 8 legs, an intraosseous needle (15-gauge Jamshidi) was inserted 1 fingerbreadth superior to the medial malleolus and flushed with 10 mL of crystalloid. Measurements included whether crystalloid was observed to flow by gravity into the drip reservoir of the intravenous tubing and whether color flow was visualized within the intraosseous space of the tibia with a 5- to 10-MHz linear transducer in color power Doppler mode, positioned just cephalad to the intraosseous needle. Intraosseous needles were then intentionally placed into the subcutaneous space just posterior to the distal tibia, and these measurements were repeated. Two blinded observers reviewed ultrasonographic video recordings and rated the presence or absence of color flow within the intraosseous space. RESULTS: Intraosseous color flow on ultrasonography correctly identified all placements, but flow into the drip reservoir was incorrect for one of the intraosseous lines (P=1.0 versus ultrasonography) and 6 of the subcutaneous lines (P=0.31 versus ultrasonography). There was perfect interobserver agreement (kappa=1) during video review. CONCLUSION: In freshly frozen cadavers, ultrasonographic visualization of flow within the intraosseous space may be a reliable method of confirming intraosseous placement. The observation of flow into the drip reservoir appears to be an unreliable indicator of intraosseous placement in fresh frozen cadavers.

Adult↗

Intraoperative videomonitoring of the facial nerve.

OBJECTIVE: To propose the application of an intraoperative videomonitoring system in otologic and otoneurologic surgery. The authors also compare results obtained by using this system with findings deriving from electromyography and pneumosensorial monitoring methods. STUDY DESIGN: The single-subject design study, involving six patients with middle ear or otoneurosurgery, compares reliability of different monitoring procedures, especially in terms of advantages and drawbacks. SETTING: Video system versus electrophysiologic and pneumosensorial systems. PATIENTS: Two patients affected with chronic otitis media, two from Meniere's disease, and two from Acoustic Neuroma. INTERVENTIONS: Intraoperative diagnostic and prognostic. RESULTS: Electrophysiologic method shows more sensibility, but is affected by a moderate grade of false positive because of electric artifacts; videomonitoring system showed less sensibility, but appears reliable; pneumosensorial system gives in-between results. CONCLUSIONS: In intraoperative monitoring techniques, reliability and feasibility are the most important factors and are achieved, in this study, by the videomonitorig system. Video recording of images have permitted further off-line analysis.

Adult↗

The effect of video-feedback on the learning of the tennis service by intermediate players.

Effects of video-feedback on improvement of the tennis service were investigated in subjects having at least 2 years of playing experience in tennis. The experiment was carried out in an indoor tennis hall under normal training conditions. Subjects were randomly divided into three groups: a video-feedback training (VFT) group, a traditional training (TT) group and a control group, each consisting of 22 subjects. While the subjects of the control group received no training at all, subjects in both the VFT and TT groups were trained twice weekly during 5 consecutive weeks. Each training session lasted 40 min, of which 30 min was spent on actual practice in training of the service. The remaining 10 min was spent on watching, analysing and discussing video recordings of either their own service performed during the training session (VFT group), or ground strokes and volleys of top level players (TT group). Both the VFT and TT group showed significantly greater improvements in both achievement scores and form (technique) scores than did the control group. No differences, however, could be demonstrated between the VFT and TT group, indicating that the subjects of the former group did not benefit from the video-feedback they received. While form scores correlated significantly (P less than 0.001) with the velocity of the served ball, no such relation between form scores and spatial accuracy was apparent.

Adult↗

Communication during trauma resuscitation: do we know what is happening?

OBJECTIVE: Verbal communication is essential for teamwork and leadership in high-intensity performances like trauma resuscitation. We evaluated communication during multidisciplinary trauma resuscitation. METHODS: The main trauma room of a level one trauma centre was equipped with a digital video recording system. Resuscitations were consecutively and prospectively enrolled. Patients with revised trauma score (RTS)=12 were resuscitated by a 'minor trauma team' and patients with RTS<12 by a 'major trauma team'. Information transferral from physicians to other team members was evaluated separately for all ABCDE's, according to initiation, audibility and response. The observer was trained and the first 30 video's were excluded. RESULTS: From May 1st to September 1st 2003, 205 resuscitations were included, 12 were lost for evaluation. The 'major trauma team' resuscitated 74 patients (ISS:21.4). Communication was audible in 56% and understandable in 44% during the primary survey. The 'minor trauma team' assessed 119 patients (ISS:7.4). Communication was audible in 43% and understandable in 33%. CONCLUSIONS: Communication during trauma resuscitation was found to be sub optimal. This is potentially harmful for trauma victims. Professionals and institutions should be aware that communication is not self-evident. Introduction of an aviation-like communication feedback system could help to optimise trauma care.

Adult↗

Correcting two-dimensional kinematic errors for chick embryonic movements in ovo.

In motor behavior studies of chick embryos in ovo, kinematic recording is limited to a single camera system and produces kinematic data that are distorted if out-of-plane movements are not considered. CONVERT is a rule based algorithm designed to calculate 3D limb movements given 2D kinematic data. CONVERT's calculations are based on a stationary reference point, limited translation of the chick embryo's trunk point, a multi-linked model of the body, and approximate limb segment lengths. Simulations indicate CONVERT calculates joint movements from 2D data with a maximum error of 6 degrees compared to a maximum error of 79 degrees if out-of-plane considerations are ignored. The approach used to correct two-dimensional kinematic measurement errors can be readily applied to other experimental conditions that restrict video recording to single camera systems.

Algorithms↗

Development of an Optical Triplicator for intravital video microscopy of oxygen saturation.

The Optical Triplicator produces three copies of a portion of a microscopic image and places them side-by-side on the face of a video image tube, so that all three images can be viewed simultaneously in each video frame. The Optical Triplicator was used in an intravital microscopy assembly to obtain simultaneous images of a microvessel at three visible wavelengths selected to enable the accurate determination of oxygen saturation in microvessels of the hamster retractor muscle. An image processing system was used to obtain light intensity and optical density from video recordings made using the triplicator. Lumenal oxygen saturation profiles were determined using the measured intensity values and a published three wavelength photometric method.

Animals↗

Comparing the effectiveness of video and written material for improving knowledge among sleep disorders clinic patients with limited literacy skills.

BACKGROUND: Health care professionals often use written material or video recordings to teach their patients without knowing which is more effective for comprehension of the information. METHODS: Patients watched either an instructional videotape about sleep apnea or read a newly designed brochure, then responded to a structured questionnaire containing 11 knowledge-based questions and 1 open-ended question (requesting suggestions for improvement of the brochure or videotape). RESULTS: Mean reported educational level was grade 12, and mean reading level was between grade 7 and 8. Using video significantly improved only two areas of knowledge for low-level (below grade 8) readers: defining sleep apnea (66% vs 43%) and identifying what continuous positive airway pressure (CPAP) does for the patient (94% vs 78%). Patients requested material with more diverse cultural representation, more information on treatment and outcomes, and fewer polysyllabic words. CONCLUSIONS: Emphasis on diagnosis and treatment, explained using simple words, should be reflected in the content of patient education brochures or videos. Providing information by video alone may have limited benefits.

Adolescent↗

Stretch-activated cation channels of leech neurons: characterization and role in neurite outgrowth.

The goal of this study was to characterize the stretch-activated ion channels (SACs) of adult identified neurons of the leech Hirudo medicinalis and to test the role of SACs in neurite outgrowth of isolated cells. Using cell-attached patch recording, we established that SACs are densely distributed in the growth cone membrane of cultured neurons. In excised patches, we found that these channels are permeable to Ca2+, as well as to monovalent cations. The channels are blocked by the extracellular application of gadolinium (Gd3+), amiloride and gentamicin. Amiloride and gentamicin, respectively, induce a partial and complete voltage-dependent block. Time-lapse video recordings of neurite outgrowth from single cultured neurons were used to study the effects of blocking SACs with gentamicin. Within 20 h of plating in the presence of the aminoglycoside, the total length of neuronal arborization was significantly greater than that measured in its absence. The amount of assembled axon per unitary surface area remained constant over 40 h and did not differ significantly with or without gentamicin. Our findings show that SACs of leech neurons admit Ca2+, are densely distributed in the growth cone membrane and exhibit typical pharmacological features of mechanotransducer ion channels. In addition, our data suggest that these cation channels participate in the early interaction between growing neurites and culture substrate.

Amiloride↗

International transmission of uncompressed endoscopic surgery images via superfast broadband Internet connections.

BACKGROUND: Although telecommunication is increasing in popularity, poor-quality images sent through a narrowband network limit its use in the medical field. METHODS: Kyushu University Hospital in Japan and four hospitals in Korea were linked via superfast broadband Internet connection. The digital video transfer system, which can transmit digital videos without loss of image quality, was used, and the bandwidth was 30 Mbps per line. RESULTS: Of the 16 teleconferences conducted, 6 demonstrated real-time endoscopic surgery. In addition to the surgical images, preoperative diagnostic images, images of the operating room, and images of the staff in the conference room were transmitted to facilitate discussion. The network remained stable, and the sound delay was restricted to less than 0.3 s. In the other 10 teleconferences, recorded video images were used for discussion. CONCLUSIONS: The authors have established a high-quality, practical teleconference system that is economical and easy to use in clinical practice. This system shows promise for remote education beyond geographic borders.

Cholecystectomy, Laparoscopic↗

Telemetric recording of neuronal activity.

A telemetric system is described which allows the wireless registration of extracellular neuronal activity and vocalization-associated skull vibrations in freely moving, socially living squirrel monkeys (Saimiri sciureus). The system consists of a carrier platform with numerous guiding tubes implanted on the skull. Custom-made microdrives are mounted on the platform, allowing the exploration of two electrode tracks at the same time. Commercially available quartz-insulated platinum-tungsten microelectrodes are used. The electrodes can be moved over a distance of 8-10 mm by turning a screw on the microdrive. Vocalization-associated skull vibrations are recorded with a piezo-ceramic element. Skull vibration signal and the signals from the two microelectrodes are fed into separate transmitters having different carrier frequencies. The signals are picked up by an antenna in the animal cage and are sent to three receivers in the central laboratory. Here, the signals are transferred via an analog/digital interface to a personal computer for data analysis and to a video recorder for long-term storage. The total weight of the head mount including carrier platform, microdrive, electrodes, skull vibration sensor, three transmitters, and protection cap is 32 g. The transmitters are powered with two rechargeable lithium batteries, allowing about 8 h of continuous recording. Reliable signal transmission is obtained over a distance of about 2 m. Recording stability allows to follow the activity of specific neurons up to several hours, with no movement artefacts during locomotion.

Animals↗

Simulated surgery in the summative assessment of general practice training: results of a trial in the Trent and Yorkshire regions.

BACKGROUND: General practice registrars are now required to undertake a summative assessment of their consulting skills. Simulated surgeries have been developed as an alternative to the existing method of assessing video-recorded consultations. AIM: To evaluate the simulated surgery assessment method, developed in the General Practice Postgraduate Education Department in Leicester, for use in assessing general practice consultation skills. METHOD: General practice registrars in Leicester performed two eight-patient simulated surgeries separated by four weeks. Assessment outcomes were compared to demonstrate the consistency of the method. Pilot surgeries in Yorkshire were videotaped, and then rated by video-raters trained for summative assessment. RESULTS: The method consistently identified those registrars who were competent and those who were not yet competent in consulting skills. It proved acceptable to candidate doctors and has fewer resource requirements for both examiners and candidates than other consulting skills assessment methods. CONCLUSION: The method developed in Leicester and successfully transferred to Yorkshire is feasible on a large scale, and offers an acceptable alternative to other consulting skills assessment methods. In this study it consistently identified competent from incompetent candidate doctors.

Clinical Competence↗